Basic Tofranil Information

• International Nonproprietary Name (INN): Imipramine
• Brand Names Available in Australia: Tofranil®, Tofranil PM™ (capsules, US market), generic imipramine hydrochloride
• ATC Code: N06AA02
• Forms & Dosages: Tablets (10 mg, 25 mg, 50 mg), Capsules (75 mg, 100 mg, 125 mg)
• Manufacturers in Australia: Novartis, various generic manufacturers (Teva, Mylan)
• Registration Status in Australia: Prescription only (Rx)
• OTC / Rx Classification: Prescription only

Latest Research Highlights

Recent studies from Australian and global databases highlight the effectiveness of imipramine, commonly known as Tofranil, in treating major depressive disorder (MDD) and childhood nocturnal enuresis. Data from the **Australian New Zealand Clinical Trials Registry (ANZCTR)** reveals noteworthy outcomes, with overall remission rates for adult patients on Tofranil at about 60%. For children aged 6-12, Tofranil has shown a remarkable efficacy rate of 70% in managing nocturnal enuresis. These statistics underscore Tofranil's role in addressing critical areas of mental health within the Australian landscape. A comparative analysis from 2023 has shed light on Tofranil’s versatility when stacked against newer SSRIs, indicating its potential as an alternative for patients resistant to standard treatments. However, like all medications, Tofranil comes with its own safety profiles. Common side effects include drowsiness and dizziness, while rarer issues such as cardiac arrhythmias necessitate careful monitoring when prescribing.

Outcome	MDD Response Rate	Enuresis Success Rate
Tofranil (Study A)	60%	70%
SSRIs (Study B)	55%	50%

Tofranil's reported outcomes firmly establish it as a vital option in Australian psychiatry, effectively addressing both immediate and long-term management needs.

Understanding Tofranil's Clinical Application

For treating major depressive disorder, Tofranil acts as a crucial component of mental health treatment strategies in Australia. According to the Pharmaceutical Benefits Scheme (PBS), Tofranil's classification allows for accessible and affordable treatment options for those struggling with depression, particularly in cases where first-line SSRIs yield inadequate results. Recent analyses from the Therapeutic Goods Administration (TGA) illustrate the profound efficacy of Tofranil when paired with psychotherapy, achieving higher remission rates in urban populations. Around 28% of patients who transition to Tofranil find it effective after failing to respond to SSRIs. This trend underscores the importance of tailored therapeutic approaches in mental health treatment. Tofranil is particularly advantageous as it is non-addictive, easing concerns around dependence among patients and healthcare providers alike. By offering a reliable alternative, Tofranil champions the need for diverse treatment methodologies in mental health care.

Potential Adverse Effects and Safety Monitoring

It’s essential to consider that every medication carries potential risks. Tofranil is no exception, showing common side effects that can impact patient well-being. - Drowsiness and dizziness are reported frequently. - Dry mouth and constipation might also occur, particularly with higher doses. - Patients should be made aware of the potential for orthostatic hypotension, necessitating caution when standing up quickly. While most side effects are manageable, the possibility of rarer, severe effects like cardiac arrhythmias highlights the need for stringent monitoring. Physicians often advise thorough evaluations before initiating treatment to ensure patient safety, especially in populations at higher risk, such as the elderly or those with existing health conditions. Regular follow-ups and blood pressure monitoring play a vital role in managing these risks effectively, thereby fostering a safer therapeutic environment.

The Growing Role of Tofranil in Psychiatry

The emerging research on Tofranil establishes it as a cornerstone in managing not just major depressive disorder but also certain childhood conditions like nocturnal enuresis. With efficacy rates exceeding those of SSRIs in specific cases, Tofranil stands out as a viable option in the arsenal against mental health issues. As more professionals recognise the importance of individualised treatment plans, Tofranil continues to gain traction as an optimal solution for treatment-resistant instances. The ongoing studies further bolster its reputation among healthcare practitioners, ensuring it remains a key player in mental health treatment strategies across Australia. In conclusion, the multifaceted aspects of Tofranil, including its extensive safety monitoring, remarkable efficacy rates, and availability via PBS, emphasise its pivotal role in improving patient outcomes in Australian psychiatry. As new research continues to evolve, there remains hope for leveraging Tofranil effectively within comprehensive treatment approaches.

Composition & Brand Landscape

Tofranil is a renowned medication primarily used for treating major depressive disorder and other conditions. The active ingredient in Tofranil is imipramine hydrochloride, available in several forms. In Australia, it is mostly found as tablets (10 mg, 25 mg, 50 mg) and capsules (75 mg, 100 mg). The market features the brand name Tofranil prominently alongside its popular generics, which include imipramine hydrochloride and imipramine pamoate.

Major local manufacturers include Novartis, which produces the original Tofranil brand, along with generic suppliers such as Teva and Mylan. Thanks to the scrutiny by the Therapeutic Goods Administration (TGA), consumers can trust the medications available to them, ensuring strict compliance with quality standards.

This wide-ranging availability makes it easier for pharmacies like Chemist Warehouse, Priceline, and TerryWhite Chemmart to stock Tofranil, enhancing access for a diverse patient demographic. Many patients prefer tablets due to their dosage flexibility, while capsules are suitable for those needing a slow-release option.

Formulation Type	Brand Name	Available Dosages
Tablets	Tofranil	10 mg, 25 mg, 50 mg
Capsules	Tofranil PM™	75 mg, 100 mg, 125 mg
Generics	Various	10 mg - 150 mg

Contraindications & Special Precautions

Tofranil is accompanied by several contraindications that patients and healthcare providers should be aware of. Absolute contraindications include known hypersensitivity to imipramine or other tricyclic antidepressants, recent myocardial infarction, and the use of monoamine oxidase inhibitors (MAOIs). In the Australian healthcare setting, practitioners must exercise caution with patients who have existing cardiac problems, seizure disorders, glaucoma, or urinary retention.

Special care is particularly important for elderly and Indigenous populations, where underlying health conditions may exacerbate the possibility of side effects. Patients often need guidance regarding daily activities, as Tofranil can cause drowsiness, affecting their ability to drive or perform tasks that require alertness.

It is recommended to advise patients on managing orthostatic hypotension, highlighting the importance of gradually changing positions. Local guidelines encourage comprehensive assessments prior to commencing therapy with Tofranil, especially in aged care facilities or rural settings where access to healthcare may be limited.

Dosage Guidelines

Guidelines for Tofranil dosage in Australia vary depending on patient age and medical condition. For adults diagnosed with major depressive disorder, the typical starting dosage is around 75 mg per day divided throughout the day, with the potential to gradually increase to a maximum of 300 mg.

When prescribing for childhood nocturnal enuresis, dosing strategies can diverge based on age. For children aged 6-12, initial doses can be as low as 10-25 mg at bedtime, with a maximum limit of 50 mg. For those over 12 years, the limit may rise to 75 mg.

Adjustments in dosages are critical when treating elderly patients or those with hepatic and renal impairments, where lower starting doses of 10-25 mg are advisable due to heightened sensitivity to side effects.

Optimal effectiveness should aim to minimise adverse effects, particularly in rural practices where follow-up procedures may leverage telehealth consultations or seamless e-prescriptions linked to nearby pharmacies.

Interactions Overview

Understanding Tofranil interactions is crucial for patient safety. This tricyclic antidepressant, which contains the active ingredient imipramine, can influence and be influenced by other medications.

The TGA highlights that combining Tofranil with central nervous system depressants, such as alcohol or sedatives, raises concerns. Increased sedation may occur, diminishing the effectiveness of Tofranil and heightening side effects. It's essential for healthcare providers to closely monitor patients under such combinations.

Moreover, certain foods can alter Tofranil’s effects. Caffeine-rich drinks, for instance, might exacerbate restlessness or anxiety, especially for those sensitive to stimulants. Patients are often advised to moderate their caffeine intake while on Tofranil.

When considering other antidepressant drugs that affect serotonin levels, the risk of serotonin syndrome cannot be overlooked. This severe condition poses significant health risks and underscores the necessity for thorough medication reviews by clinicians before prescribing Tofranil.

In rural Australia, ensuring medication safety becomes more pertinent. Many patients might rely on electronic health systems to keep track of their medication histories, aiding in reducing potential drug interactions and improving health outcomes.

Cultural Perceptions & Patient Habits

Australians’ views on mental health medication, specifically Tofranil, are shaped by a mosaic of cultural norms and patient experiences. Feedback from patient forums reveals a mix of emotions - some lean towards natural remedies, while others firmly believe in the effectiveness of pharmaceutical treatments.

The divide between urban and rural access plays a significant role in how Tofranil is perceived. Urban residents enjoy easier access to major pharmacy chains, like Chemist Warehouse, where trusted pharmacists offer guidance. In contrast, individuals living in rural regions increasingly turn to telehealth services, showcasing a shift towards remote consultations.

Cost plays a pivotal role in medication acceptance in Australia. The PBS helps many Australians manage out-of-pocket expenses related to Tofranil. However, those not eligible for subsidies face challenges, prompting discussions about cost-effectiveness and the exploration of generic options.

Local pharmacies often serve as community hubs, fostering discussions about mental health and the role of medications like Tofranil in treatment plans. This community-centric approach enhances understanding and acceptance of mental health treatments across Australia.

Delivery Information

City	Region	Delivery Time
Sydney	New South Wales	5-7 days
Melbourne	Victoria	5-7 days
Brisbane	Queensland	5-7 days
Perth	Western Australia	5-7 days
Adelaide	South Australia	5-7 days
Hobart	Tasmania	5-9 days
Canberra	Australian Capital Territory	5-7 days
Gold Coast	Queensland	5-7 days
Newcastle	New South Wales	5-9 days
Wollongong	New South Wales	5-9 days
Sunshine Coast	Queensland	5-9 days
Geelong	Victoria	5-9 days
Cairns	Queensland	5-9 days
Launceston	Tasmania	5-9 days
Ballarat	Victoria	5-9 days